JESSIRAE BROUSSARD AA
NPI 1326452962
Anesthesiologist Assistant in Liberty, MO

Q: What is Jessirae Broussard's NPI number?

The NPI number for Jessirae Broussard is 1326452962. It was assigned to this individual provider in the NPPES registry on June 11, 2014.

Q: What is Jessirae Broussard's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Active since June 11, 2014Accepts Medicare Assignment

2525 GLENN HENDREN DR, ANESTHESIA DEPT, LIBERTY, MO 64068(816) 781-7200(816) 792-7196 Get Directions Write a Review

NPPES record last updated: December 9, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Jessirae Broussard Aa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSIRAE BROUSSARD AA (NPI 1326452962) is an individual anesthesiologist assistant in Liberty, Missouri, licensed in Missouri (2014018078) and active in the NPI registry since June 2014. She is affiliated with New Liberty Hospital District and is a graduate of Other (2014).

NPPES Registry Identity

NPI1326452962

Entity TypeIndividualFemale

Primary Taxonomy367H00000X

Provider Legal NameJESSIRAE BROUSSARDCredential: AA

Location Address2525 GLENN HENDREN DR, ANESTHESIA DEPTLiberty, MO 64068-9625

Mailing AddressPo Box 804408Kansas City, MO 64180-4408 · (913) 647-4100 · Fax (913) 647-4120

Phone(816) 781-7200

Fax(816) 792-7196

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateJune 11, 2014

Last NPPES UpdateDecember 9, 2020

NPPES CertifiedDecember 9, 2020

✔ NPI 1326452962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

License✔ Licensed in MO · 2014018078

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

2525 GLENN HENDREN DR, Liberty, MO 64068

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Other Identifiers 3

Other50498011MO · Bcbs Kc

OtherP01350390MO · Railroad

Medicaid1326452962MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas City.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jessirae Broussard Aa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456576610

PECOS Enrollment IDI20140701001325

Medicare Billing Reassignment

Medicare enrollment records show Jessirae Broussard reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Professional Anesthetic Care Inc

Same address

Anesthesiology

2525 GLENN HENDREN DR
Liberty, MO 64068

Reassigned Medicare billing, Missouri enrollment
73 clinicians in this Medicare group

NPI 1922053461 (816) 461-8288

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

13 services13 patients

Anesthesia for other procedure on large bowel using an endoscope 00811

Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

New Liberty Hospital District

Acute Care Hospitals · Liberty, MO

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number260177

Location2525 Glenn Hendren DrLiberty, MO 64069 · Clay County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIE ANNE MARX D.O.

Internal Medicine